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Wake up to better care


24 September 2012

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With 40 practices, covering a practice population of 350,000, NHS Wakefield Clinical Commissioning Group (CCG) covers the same geographic boundaries as its local authority – Wakefield Council.

With a history of 100% fund holding, the CCG was originally formed from six practice-based commissioning groups. We came together under the name Wakefield Alliance in spring 2011. The remaining two practices on the edge of the district the Alliance was working with recently joined us.

With 40 practices, covering a practice population of 350,000, NHS Wakefield Clinical Commissioning Group (CCG) covers the same geographic boundaries as its local authority – Wakefield Council.

With a history of 100% fund holding, the CCG was originally formed from six practice-based commissioning groups. We came together under the name Wakefield Alliance in spring 2011. The remaining two practices on the edge of the district the Alliance was working with recently joined us.

The Alliance Board was established in March 2011 and became a sub-committee of the NHS Calderdale, Kirklees and Wakefield District Board in October 2011. We chose to drop the word Alliance to meet the DH guidance on CCG naming. At the moment we’re preparing for first wave authorisation, in July. Authorisation isn’t an end in itself, but it will demonstrate that we’re on the right path in preparing to lead the NHS locally.

As chairman, I’m supported by the NHS Wakefield CCG Board which is made up of representatives from member practices, including a practice manager, nursing members, non-executive and lay members plus our shadow accountable officer who was formerly the director of commissioning at
NHS Wakefield District, the primary care trust (PCT).

Essentially, the CCG board has now had the entire PCT commissioning budget devolved to it. We get our commissioning support from the emerging West
Yorkshire Commissioning Support Service – although some posts are held jointly with a neighbouring CCG to reflect our joint commissioning responsibilities with an acute provider.

Wakefield district

The Wakefield district is one of contrasts. The east of the district is a typical ex-mining district, whereas the west is more affluent, particularly along the M1 motorway corridors. Health inequalities are extensive and the overall level of deprivation in the district is significantly worse than the UK average. Those living in the most deprived areas experience the poorest health and the shortest life expectancy.

The district is particularly affected by low levels of skills and training and high levels of ill health, disability and employment deprivation. It has higher than average levels of smoking, obesity, coronary heart disease and respiratory illness, particularly chronic obstructive pulmonary disease (COPD).

Looking at the local joint strategic needs assessment, the CCG has agreed our priorities for the next three years as:

•    Developing preventative services and advice, including family health and well being.
•    Providing more care and treatment in out-of-hospital settings, in primary care, and closer to home.
•    Enhancing services and improving dignity for older people, including those people who need dementia care, and their carers.
•    Further developing responsive urgent care services.
•    Ensuring supported end of life care.
•    Effectively managing long-term conditions.
•    Investing in supportive maternity, children and young people’s services.

These priorities underpin an ongoing ‘whole system’ transformation of local health and social care services, which is being led by the local partnership board of which we are a key player.

We’re particularly focused on care outside hospital, urgent care and children’s services and our aim is to develop services that are integrated, effective and sustainable and will support Mid Yorkshire Hospitals NHS Trust (our local acute service provider) on its journey to foundation trust status.

Medicines management is a local success story. Last year we saved £4.2m from a budget of £62m thanks to our medicines management team which actively engaged member practices in a common goal and collective working.

Vision

Our vision is clear: to be locally valued. We aspire to commission quality services which will improve patients’ experiences of care and their health outcomes. We believe that involving and listening to patients, practices, partners and staff is and will continue to be a key part of redesigning local services.

As well as the priorities I’ve already mentioned, we are really keen to provide a creative and empowering environment for our member practices. By this I mean ways of working which support and stimulate innovation and allow them to unleash their potential. Member practice involvement and collaboration has been really important to the CCG over the past twelve months, and we’ve set up a practice support unit to provide practical help and support for practices as they develop.

Our member practices have recently signed a memorandum of understanding, based on the following principles:

•    Honesty based on transparency.
•    Abiding by their vision to be locally valued.
•    Respecting opinions and valuing differences.
•    Working collaboratively, both formally and informally.
•    Managing dissent.
•    Clear communication in plain language.
•    Ownership of problems and opportunities at practice level.
•    A commitment to cost improvement and living within
our means.
•    Being bound by decisions.
•    Developing a sophisticated understanding of performance and quality in practice.

The future

Where would I like the CCG to be in five years’ time? I’d like to see a mature organisation with strong, developed partnerships, doing its best for local people by improving both their outcomes and their experiences of healthcare: to be truly locally valued.

Dr Phil Earnshaw, Chair of NHS Wakefield Clinical Commissioning Group, Ferrybridge GP

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